Chicken pox outbreak reported at day care center in Westbrook

Five children who go to the The Little Red School House Too have fallen
ill, and unvaccinated kids must stay at home for 21 days, but the Maine
CDC has not issued a health alert.

A Westbrook day care center has reported a chicken pox outbreak in
which five children have been sickened by the infectious disease, and
some other children will be kept out of the center for 21 days.

According to an email to parents from The Little Red School House
Too, there have been “five confirmed cases of chicken pox at the center.
Unfortunately, now that there are more than three cases, the CDC
considers this an outbreak and requires all unvaccinated children
quarantined at home until 21 days after the date of the last diagnosed
case. At this time, Monday, June 4, is when we will be able to have all
unvaccinated children return to the center.”

A staff member at the center declined to comment Wednesday, and the center’s owner, Rebecca Palmer, did not respond to messages.

After the Portland Press Herald obtained the email identifying the
location of the outbreak, the Maine Center for Disease Control and
Prevention confirmed that there were “several cases” of chicken pox at
The Little Red School House Too.

Related

Maine CDC spokeswoman Emily Spencer said the agency did not issue a
“health alert” about the situation. Health alerts provide notice to
health care professionals across the state that an outbreak has occurred
so they are aware of infectious diseases that are circulating. An
outbreak is defined as three or more cases of an infectious disease
being reported at one location, such as a school, day care center or
restaurant.

“We don’t issue Health Alerts
when the event occurs at a single location. Health Alerts are issued
when there is an outbreak across a region – like throughout a county,
for example,” Spencer said in an email. “The CDC works with the
institution affected to keep everyone updated, including parents,
teachers, staff, and local providers as needed.”

OUTBREAK’S ORIGIN UNCLEAR

The
Maine CDC worked with the Westbrook day care center on informing
parents about the outbreak, including an information sheet on the
disease.

Spencer said she couldn’t comment on whether the outbreak started in
an unvaccinated child whose parents opted out of immunization on
religious or philosophic grounds, which parents are permitted to do
under state law. The Little Red School House Too has a capacity of 100
children, according to Maine Department of Health and Human Services
licensing information.

Chicken pox, or varicella, is extremely contagious. In many cases it
leads to mild symptoms, but in some cases it can be a severe infection
requiring hospitalization. Children can be vaccinated for chicken pox
starting at age 1; infants less than 1 year old are too young to be
immunized.

Maine parents can opt out of having their children receive required
vaccinations for school or day care by signing a form indicating they
have philosophic or religious objections. It’s not clear what the
opt-out rate is for Maine children in day care; however, in the past
several years the state has consistently had one of the highest
vaccination opt-out rates in the nation for children entering
kindergarten, according to the U.S. Centers for Disease Control and
Prevention.

Maine’s voluntary opt-out rate for children entering kindergarten in 2016-17 was 4.8 percent, the seventh-highest in the nation and more than double the national average of 1.8 percent.

Myths about vaccines causing autism have persisted since 1998, when a
since-retracted study in a British medical journal incorrectly claimed a
link. Numerous studies since then have proven there is no connection
between autism and vaccines, and that vaccines are overwhelmingly safe.

There have been 66 reported cases of varicella in the state through
April of this year, according to the Maine CDC, slightly above the
five-year average. There were 196 cases in all of 2017, and 228 cases in
2016.

PREVENTABLE WITH VACCINE

Dr. Laura Blaisdell, a Yarmouth pediatrician, said the disease has
been preventable since the vaccine was introduced in the 1990s.
Nationwide, there were about 4 million cases of chicken pox per year in
the 1990s before the vaccine was introduced, resulting in about 10,000
hospitalizations annually and about 100 deaths, according to the federal
CDC. Recent national data is lacking because some states do not report
chicken pox cases, but the federal CDC estimates that the vaccine has
prevented at least 3.5 million cases of varicella every year.

“It is an entirely preventable disease. We don’t need to have chicken
pox circulating in our environment,” Blaisdell said. She noted that for
a day care center, having numerous children out because of sickness is
not only a medical problem, but also a financial hardship for working
parents and the business.

The day care center’s email to
parents said that because children under age 1 aren’t old enough to be
vaccinated, tuition will not be charged to those families during the
time the children are quarantined. However, “all other age groups will
continue to pay their normal weekly tuition because they have the option
of being vaccinated and continuing care.”

The Maine CDC sent a letter to the day care center’s parents describing chicken pox as a “very contagious virus.”

“It usually begins as a mild illness with fever, headache, tiredness
and loss of appetite. 1-2 days later, an itchy rash that starts as
small, red bumps will appear. Those bumps then become blistered, ooze
and then crust over,” the letter said. “The rash appears about two weeks
(14-21 days) after exposure. Most people with chicken pox recover
without any problems, but for some it can be severe or lead to
complications.”

A bill to make it more difficult for parents to opt out of
vaccinations required for schools and day care centers – by mandating
that parents obtain the signature of a health professional – was vetoed
by Gov. Paul LePage in 2015, and the Maine House that July fell five votes short of overriding the veto.

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